[Diagnosis of sore throat. A multipractice study of 3 different ways of antigenic determination for detection of group A streptococci in throat swabs]

During five months in the winter of 1992/1993, 34 general practitioners (GPs) from 18 offices participated in a clinical testing of three group A streptococcal antigen detection test (ADT) kits (Abbott TestPack Strep A Plus (Abbott), Concise Strep A, Hybritech (Concise) and Kodak SureCell Strep A (Kodak)). The GPs obtained duplicate throat swabs, one for processing with the ADT kit, the other for culture reference at The Streptococcus Laboratory (Bacteriological Department, Statens Seruminstitut, Copenhagen). A total of 1389 patients were enrolled in the study, thirty percent of whom were infected by group A streptococci. The following results were obtained: Abbott: Sensitivity: 76%, specificity: 99%, positive predictive value: 97%, negative predictive value: 91%. Concise: Sensitivity: 82%, specificity: 95%, positive predictive value: 86%, negative predictive value: 92%. Kodak: Sensitivity: 84%, specificity: 87%, positive predictive value: 73%, negative predictive value: 93%. As a follow-up to the main study, each GP filled in a questionnaire, stating his opinion about the investigated ADT kit. Considering the practical handiness, Concise scored higher than Abbott, which in turn scored higher than Kodak. In conclusion, Abbott and Concise are recommended for the diagnosis of group A streptococcal pharyngotonsillitis in general practice.

[Course and prognosis of subacute cutaneous lupus erythematosus. A prospective study of 34 patients]

34 patients with subacute cutaneous lupus erythematosus (SCLE) were prospectively followed up and examined twice in 1986-1989 and 1990-1991, with a minimal interval of 2 years. The findings obtained were documented in a computerized registry and were evaluated by computer-assisted analysis. Thirty-one women and three men aged 23-66 years at the time of the first documentation (FD) were included in the study. The disease had lasted an average 6.5 years (from a few months to 39 years). Prominent cutaneous manifestations of SCLE were shown by 79.4% of the patients at the first visit compared to 58.8% at the second documentation (SD), whereas the incidence of acrolocalized vasculitis increased (FD 20.6%, SD 41.2%), as did that of Raynaud phenomenon (FD 20.6%, SD 26.5%). Mild extracutaneous symptomatology was found in 70.6% (FD) and in 85.3% (SD) of the SCLE patients. Arthralgia (FD 47%, SD 61.8%) and symptoms suggesting some involvement of the peripheral or central nervous system (FD 29.4%, SD 50%) were noted most frequently. Overall, during the follow-up there was a quantitative mild increase of extracutaneous symptomatology; a significant correlation between the presence of acrolocalized vasculitis and arthralgia was found. In conclusion, the prognosis of SCLE appears rather benign; fulminant courses were not observed. However, the risk of mild systemic involvement clearly increases during the prospective course of the disease, whereby acrolocalized vasculitis can be regarded as a cutaneous marker for extracutaneous manifestations.

Lautropia mirabilis gen. nov., sp. nov., a gram-negative motile coccus with unusual morphology isolated from the human mouth

An organism that seems to be identical to Orskov's 'Sarcina mirabilis' [Orskov, J. (1930) Acta Pathol Microbiol Scand Suppl III, 519-541] has been rediscovered in specimens from the upper respiratory tract of humans. Six strains were studied, and the results, which conformed to Orskov's description of S. mirabilis, were as follows. Rough to smooth colonies grow on many plated media and show extremely polymorphic cell morphology with round cells with diameters from 1 to > 10 microns. The smallest cells were often motile with circular movements. Strains were Gram-negative, facultatively anaerobic, oxidase and urease positive, and weakly catalase positive. Nitrate and nitrite were reduced, and glucose, fructose, sucrose and mannitol were fermented. Polysaccharide was produced on sucrose agar. Electron microscopy showed coccoid cells with a bundle of three to nine flagella, a Gram-negative cell-wall morphology, and aggregates of irregular cells held together by a common surface layer. The mean mol% (G+C) of the organisms was 65.0. 16S-ribosomal RNA sequencing revealed that the organism belongs to the beta subgroup of Proteobacteria, separate from all other described genera, but most closely related to Burkholderia. The name Lautropia mirabilis is proposed for this organism.

Human cytomegalovirus IE86 protein interacts with promoter-bound TATA-binding protein via a specific region distinct from the autorepression domain

The major immediate-early gene of human cytomegalovirus encodes several isoforms of an immediate-early protein which has distinct transcriptional regulatory properties. The IE86 isoform autorepresses the major immediate-early promoter by directly binding the cis repression signal element located between the TATA box and the mRNA cap site. In addition to this activity, IE86 stimulates other viral and cellular promoters. One mechanism by which eukaryotic regulatory proteins are thought to stimulate transcription is by contacting one or more general transcription factors. We show that the IE86 protein physically interacts with the DNA-binding subunit (TATA-binding protein) human transcription factor IID via the TATA-binding protein-contacting domain in the N terminus of IE86. In a mobility shift assay, IE86 was also observed to stabilize the binding of TATA-binding protein to promoter DNA. The domains within IE86 responsible for mediating transactivation and repression functioned independently. These experiments thus demonstrate the elegant ability of human cytomegalovirus to join different protein domains to produce distinct multifunctional proteins.

Direct interaction of the human cytomegalovirus IE86 protein with the cis repression signal does not preclude TBP from binding to the TATA box

The human cytomegalovirus major immediate-early gene encodes several protein isoforms which autoregulate the major immediate-early promoter (MIEP). One of these isoforms, the IE86 protein, represses the MIEP through a DNA sequence located between the TATA box and the transcription initiation site, designated the cis repression signal (crs). Through mutational analysis, amino acid domains within IE86 responsible for binding the crs element were located at the C terminus. Mutation of the putative zinc finger domain, which precluded IE86 from binding DNA, converted the protein from a repressor of MIEP transcription into an activator. DNase I protection analysis demonstrated that the IE86 footprint overlapped the sequence protected by the TATA-binding protein (TBP). Investigation of whether IE86 was able to displace TBP from DNA revealed that both proteins could bind DNA simultaneously. However, higher concentrations of IE86 were required to obtain protection of the crs element in the presence of prebound TBP. Similarly, higher concentrations of TBP were required to obtain protection in the presence of prebound IE86. These observations indicate that steric hinderance impairs but does not prevent both proteins from binding DNA synchronously.

Clinical and experimental evaluation of intermittent intraoperative short-term expansion

To assist in the closure of defects in the region of the head lack and neck, a number of surgeons recommend intermittent intraoperative short-term expansion to exploit the biomechanical properties of the skin. It was the aim of this study to assess quantitatively the amount of intraoperative "tissue gain," to analyze its origin, and to throw light on its underlying biomechanical processes. A total of 285 expansions in 5-minute intervals under a constant tissue pressure of 100 mmHg were performed on 30 patients with severe microtia. The volumes achieved were protocolled, and microcirculation was monitored with the help of a laser-Doppler flowmeter. Expanders exerting a tissue pressure of 100 mmHg for more than 80 cycles lasting 20 minutes also were employed in five dogs. Apart from determining the volumes, changes in distance between the skin tattoos and the diameter of the expander base were recorded. A volume increase of about 10 percent per hour was recorded for the human patients and an increase of about 30 percent per hour for the animals. After reaching a maximal increase in length of 15 to 20 percent, there was no further skin elongation despite increasing volumes. Instead, the expander began to move into the subcutaneous tissue so that its diameter showed a continuous increase. We can conclude on the basis of these results that the increase in volume during intermittent intraoperative short-term expansion is not caused by the proclaimed "creep" behavior of the skin.

Acute mercury poisoning (acrodynia) mimicking pheochromocytoma in an adolescent

A 14-year-old boy was seen because of irritability, insomnia, lethargy, and profuse sweating, together with hypertension (blood pressure: 160/120 mm Hg), tachycardia, and a diffuse erythematous rash with desquamation of the palms and soles. Initial biochemical investigation suggested a diagnosis of pheochromocytoma, but subsequently a history of exposure to mercury vapor was obtained. This case emphasizes the clinical and biochemical similarities between mercury poisoning (acrodynia) and pheochromocytoma.

[Comparative study of immunologic consequences of autotransfusion and homologous transfusion in lung cancer surgery]

A study was carried out to determine the effects of transfusion with either autologous or homologous blood in 35 patients with lung cancer undergoing lung surgery. The patients were randomly allocated to two groups, "allo" receiving homologous blood (n = 10), and "auto" receiving autologous blood only (n = 13). A third control group included the patients (n = 12) who had not required any blood. In patients of "auto" group, two blood removals of 7 ml.kg-1 each were performed, provided their haemoglobin concentration was over 110 g.l-1 and their haematocrit over 34%. The following parameters were studied at t-1 (the day of inclusion), t0 (just before surgery and transfusion), t1 (one week after surgery), and t2 (one month later): haematocrit and haemoglobin concentration; IgG, IgA and IgM concentrations; polymorphonuclear and neutrophil leucocyte and lymphocyte numbers, lymphocyte subpopulations (CD4/CD8), activated natural killers (NK), polymorphonuclear leukocyte chemotaxis and chemoluminescence. Anaesthesia and surgery initiated initiated an early decrease in immunity in all three groups. The immune profile, and its time course in patients who received autologous blood only was similar to that of those who were not transfused at all. On the other hand, homologous blood transfusion seems to modify the recipient's non specific immune system. In group "allo", a decrease occurred in the number of auxiliary lymphocytes CD4, an increase in suppressor lymphocyte numbers CD8, with an increase in the CD4/CD8 ratio, and no increase in NK activity. These data suggest that autologous transfusion is well tolerated in cancer patients undergoing surgery.

An algorithm for a selective use of throat swabs in the diagnosis of group A streptococcal pharyngo-tonsillitis in general practice

A prospective evaluation was made of an algorithm for a selective use of throat swabs in patients with sore throat in general practice. The algorithm states that a throat swab should be obtained (a) in all children younger than 15 years; (b) in patients aged 15 years or more who have pain on swallowing and at least three of four signs (enlarged or hyperaemic tonsils; exudate; enlarged or tender angular lymph nodes; and a temperature > or = 38 degrees C); and (c) in adults aged 15-44 years with pain on swallowing and one or two of the four signs, but not both cough and coryza. Group A streptococci were found by laboratory culture in 30% of throat swabs from 1783 patients. Using these results as the reference, the algorithm was 95% sensitive and 26% specific, and assigned 80% of the patients to be swabbed. Its positive and negative predictive values in this setting were 36% and 92%, respectively. It is concluded that this algorithm may be useful in general practice.

Aspergillus fumigatus fungaemia and myocarditis in a patient with acquired immunodeficiency syndrome

Necrotizing myocarditis due to Aspergillus fumigatus was a contributory cause of death in a patient with acquired immunodeficiency syndrome and non-Hodgkin lymphoblastic malignant lymphoma of the Burkitt type. A transient remission of the lymphoma had been obtained by cytostatic treatment. A. fumigatus was isolated from blood two weeks before death, but myocarditis was not diagnosed until autopsy.

Does physical exercise influence bowel transit time in healthy young men?

An examination was performed on 20 healthy men, who had a specific diet, to test the influence of moderate physical activity on bowel transit. During a 3-day pause and a 3-day phase of easy sports activity (jogging), oro-anal transit was measured with the help of radiopaque markers (Hinton method). While the subject was under exertion, the entire weight of stool rose significantly (743 vs. 600 g), whereas we found no significant influence on the oro-anal transit time (39 vs. 48 h) or on stool frequency (1.3 vs. 1.3 per day). Moderate physical activity had no effect on bowel transit time of healthy men under a constant diet. The effect of the so often recommended increase of physical activity on constipation remains to be elucidated.

Rejection prophylaxis with interleukin-2 receptor antibody BT 563: mechanisms of action on human cells

We investigated the in vitro immunosuppressive effect of BT 563, a monoclonal antibody, against the alpha-chain of the human interleukin-2 (IL-2) receptor (p 55), which has been used to prevent transplant rejection in several clinical trials. We also measured the proliferative T cell alloresponse and pCTL frequencies of BT563-treated kidney transplant patients. In mixed lymphocyte cultures BT 563 caused a reduction of T cell proliferation to about 50%. This could not be reversed by the addition of exogenous IL-2. A more effective reduction (80%) was seen in the generation of cytotoxic T cells from CML cultures and at the clonal level. The specific T cell response after preincubation with antigen and BT 563 was not reduced so that BT 563 did not induce tolerance. The in vitro findings indicated that BT 563 had a significant but incomplete immunosuppressive effect. This correlated with the clinical course and ex vivo analysis of PBL from BT 563-treated patients after kidney transplantation.

[Caries in the permanent teeth of 7- to 15-year-old Hamburg pupils]

The dental health status of 2193 seven- to fifteen-year old pupils was evaluated in Hamburg. A total of 20.6% of these school children hat caries-free dentitions. Among the seven-year-old children this figure was 43.4% and it dropped down to 4.8% among the fifteen-year old ones. DMFS values increased from 1.0% to 13.8% between the same groups. Obviously, caries prevalence was increasing to a statistically significant degree with the lower social classes.

Alpha B crystallin accumulation is a specific response to Ha-ras and v-mos oncogene expression in mouse NIH 3T3 fibroblasts

The conditional expression of the v-mos and Ha-ras(EJ) oncogenes in NIH 3T3 cells leads to the accumulation of a 23-kDa protein (p23) (R. Klemenz, S. Hoffmann, R. Jaggi, and A.-K. Werenskiold, Oncogene 4:799-803, 1989). We purified p23 to homogeneity and determined part of the amino acid sequence. The obtained sequence is identical with that of the eye lens protein alpha B crystallin. Northern (RNA) blot and Western immunoblot experiments were performed to demonstrate that alpha B crystallin mRNA and protein do indeed accumulate as a consequence of v-mos and Ha-ras oncogene expression. Comparison of cDNA clones obtained from the mRNA of eye lenses and of oncogene-expressing fibroblasts revealed identity between them. The major transcription initiation site of the alpha B crystallin gene in our experimental system was shown by primer extension experiments to be identical with the one used in eye epithelial cells. In addition, we identified a second minor initiation site 49 nucleotides further upstream. Serum growth factors did not stimulate alpha B crystallin expression in growth-arrested cells.

Low yield of screening for cryptococcal antigen by latex agglutination assay on serum and cerebrospinal fluid from Danish patients with AIDS or ARC

From July 1, 1989 to September 5, 1990, 530 serum specimens and 50 cerebrospinal fluid (CSF) specimens from 334 HIV-1 infected patients, most of whom had AIDS or ARC, were analysed in a cryptococcal antigen latex agglutination assay, and all were negative. Three cases of meningitis due to Cryptococcus neoformans diagnosed by microscopy and culture in 3 HIV-1 infected patients are presented. Stored specimens of serum and CSF from these patients were assayed for cryptococcal antigen, and in all 3 the onset of meningitis was preceded by the presence of cryptococcal antigen in serum. It is concluded that the low occurrence of cryptococcosis in our patient population does not justify a routine serum screening for cryptococcal antigen.

Phase I-II study on weekly administration of pirarubicin in patients with metastatic breast cancer

A phase I-II study of weekly low-dose pirarubicin was performed in 19 patients with advanced breast cancer. The goal was to establish the optimal dose intensity, i.e., the maximal dose applicable at tolerable toxicity within the intended schedule. Each of the four different dose groups used (20, 24, 25, and 27 mg/m2) comprised 4-5 patients. In over 47% of patients, objective remissions were obtained (confidence interval 26%; 71%) including one complete and eight partial remissions; the median duration of remission was 41 weeks (range 16-72), and the median time to reach remission was 12 weeks (range 6-36). Efficacy of treatment was more dependent on prior chemotherapy than on pirarubicin dosage. The weekly i.v. push injection of the drug was easily applicable at an outpatient clinic and well tolerated. WHO grade 3 was the highest toxicity observed for leukopenia (3/19), leukopenia associated with infection (1/19), nausea/vomiting (2/19) and alopecia (6/19). More severe myelosuppression was avoided by interrupting the weekly application until recovery of leukocytes to greater than or equal to 3.5 x 10(3)/mm3. No clinical signs of cardiotoxicity were observed. Generally, mild to moderate signs of cardiac dysfunction acquired during therapy were detected by special cardiac monitoring. Only in 3 of 19 patients was a cumulative dose of more than 550 mg/m2 surpassed. This was accepted as the upper limit for conventional anthracycline therapy. The median cumulative dose applied was 325 mg/m2/week (range 58.2-800.0). Because of maldistribution of prognostic factors, no dose-response relationship could be established. With respect to the total time for which each patient was studied, the dose group of 27 mg/m2 achieved the highest dose intensity with a median of 17.4 mg/m2/week (range 13.5-22.4). Therefore, the dosage of 27 mg/m2/week is recommended to be used in further phase II-III trials of weekly applied pirarubicin.

Detection of group A streptococcal antigen from throat swabs with five diagnostic kits in general practice

During a 5-month period, 248 general practitioners from 164 general practice offices obtained duplicate throat swabs from 2469 patients with acute pharyngotonsillitis. At the general practice office, one of the swabs was assayed for the presence of group A streptococcal antigen, using one of five commercially available diagnostic kits. (The participants did not receive instruction in the use of the kits). The other swab was cultured in our laboratory for the presence of group A streptococci. The diagnostic parameters for the five kits were as follows: Abbott TestPack Strep A--sensitivity, 79% (110/139) and specificity, 98% (490/501); Direct Strep A EIA (Roche)--sensitivity, 79% (104/132) and specificity, 63% (178/281); Respirastick--sensitivity, 55% (46/84) and specificity, 96% (298/309); Reveal Colour Strep A--sensitivity, 82% (114/139) and specificity, 83% (223/268); Tandem ICON Strep A--sensitivity, 78% (111/143) and specificity, 98% (362/368). The antigen detection test results were heavily influenced by the clinical prediction of a streptococcal or viral etiology. It is concluded that in the absence of a standard throat culture, the Abbott TestPack Strep A kit and the Tandem ICON Strep A kit both offer a more safe diagnostic alternative than clinical assessment. Depending on the current prevalence of group A streptococci, the additional use of a throat swab culture should be considered in case of negative antigen detection test results.

Pseudallescheria boydii infection of the central nervous system

Pseudallescheria boydii is a rare cause of central nervous system infection characteristically presenting as a neutrophilic meningitis or multiple brain abscesses. Factors predisposing to central nervous system infection with this fungus include immunosuppression and near drowning. The organism is infrequently cultured from fluid obtained by lumbar puncture, delaying clinical recognition and appropriate antifungal therapy. All untreated patients with P boydii infection of the central nervous system died. We describe a patient who developed a persistent neutrophilic meningitis with focal neurologic deficits due to P boydii 6 months after a freshwater aspiration pneumonia. We also review the characteristic clinical and pathologic features of previously reported cases and emphasize the importance of early detection and treatment in the management of this frequently intractable disease.

Induction of a mitogen-responsive gene after expression of the Ha-ras oncogene in NIH 3T3 fibroblasts

A cDNA clone, T1, has been isolated whose corresponding mRNA was transiently expressed at highly elevated levels after conditional expression of the Ha-ras(EJ) gene and after mitogenic activation of quiescent NIH 3T3 cells. Glucocorticoid hormone stimulated substantial T1 expression as well but only in proliferating cells. At least two different signaling pathways participate in the regulation of the T1 gene: a protein kinase C-dependent signal is involved in the response of proliferating NIH 3T3 cells to glucocorticoid in the absence but not the presence of p21ras, whereas a protein kinase C-independent mechanism mediates the response to serum factors. Treatment of cells with the protein kinase inhibitor 2-aminopurine blocked induction of expression of the T1 gene. T1 mRNA accumulation is regulated at the transcriptional level.

Induction of stable chimerism and elimination of graft-versus-host disease by depletion of T lymphocytes from bone marrow using immunomagnetic beads

The goal of transplantation is the induction of immunologic tolerance. At present, nonspecific immunosuppression is used to prevent graft rejection and, commonly, graft-versus-host disease (GVHD). Nevertheless, nonspecific immunosuppressive therapy is frequently complicated by infection, malignant tumors, and drug toxicity. In order to examine whether hematopoietic chimerism can be used to induce specific allograft tolerance, we have reconstituted lethally irradiated Lewis rats with ACI bone marrow that has been depleted of T cells with use of immunomagnetic beads. This technique consists of binding OX-19, a mouse anti-rat pan-T lymphocyte monoclonal antibody, to magnetic polymer beads. Mixing of bone marrow or splenocytes with the bead/OX-19 complexes, followed by magnetic separation, results in significant depletion of T cells with minimal nonspecific cell loss. Immunomagnetic T-cell depletion of bone marrow, followed by reconstitution of a lethally irradiated host, allows for the development of stable, mixed hematopoietic chimerae without evidence of GVHD. These hosts are immunocompetent by clinical criteria. Recipients of untreated donor bone marrow that did or did not receive nonspecific immunosuppression demonstrated varying degrees of GVHD and reduced survival. The ability to rapidly and simply deplete T lymphocytes from bone marrow and produce stable, immunocompetent hematopoietic chimerae without GVHD may be an important method for tolerance induction to vascularized allografts.

Successful fibrin seal closure of a contaminated fistula. Case report

In a 43-year-old woman, a large, contaminated fistula, initially with vesicointestinal communication, was successfully closed by application of fibrin seal. The course of three sealing attempts indicated that local pretreatment with antibiotics may have been important for the final result. At 4-year follow-up examination there was no recurrence of the fistula.

Serum- and oncoprotein-mediated induction of a gene with sequence similarity to the gene encoding carcinoembryonic antigen

We describe the molecular identification of a gene, designated T1, whose expression in mouse NIH 3T3 cells is strongly induced by the Ha-ras(EJ) and v-mos oncogenes and by serum. The T1 gene encodes a 38.5-kDa protein, as predicted from its primary sequence and shown by in vitro translation. The protein was processed at its amino terminus and extensively modified by N-linked glycosylation in vitro in the presence of microsomal vesicles. Sequence comparison of T1 with the MIPSX data base (Max-Planck-Institut für Biochemie, Martinsried/Munich) revealed similarity to the human carcinoembryonic antigen, a tumor marker which is overexpressed in colon adenocarcinomas and in fetal tissues. Considerable sequence similarity has also been observed to the short conserved region of other proteins which, like carcinoembryonic antigen, are encoded by members of the immunoglobulin gene superfamily.

The v-mos and c-Ha-ras oncoproteins exert similar effects on the pattern of protein synthesis

The effects of the ras and the mos oncogene products on the pattern of newly synthesized proteins was investigated in NIH3T3 cell lines. A conditional expression system which allowed hormonal induction of the oncogenes was utilized to detect effects on the accumulation of oncoproteins by two dimensional gel electrophoresis of crude cell extracts. Strong and reproducible changes of protein synthesis following the expression of the ras and mos oncogenes were detected. Transiently induced synthesis of four proteins with a molecular mass of 23 kDa, 32 kDa, 35 kDa, and 47 kDa was observed. These changes were qualitatively indistinguishable in both, ras and mos oncogene expressing cells. This is in agreement with the notion that the two oncogene products act on a common signal transduction pathway. Serum mediated growth induction of quiescent NIH3T3 cells led to a different pattern of altered protein synthesis. We observed the transient alteration in the synthesis rates of three proteins with a molecular mass of 27 kDa, 47 kDa and 52 kDa. Only the 47 kDa protein was also subject to regulation by the oncoproteins. One of the proteins whose synthesis was strongly induced by the ras and mos oncogene products is also expressed by heat shock.

Intraincisional antibiotic in addition to systemic antibiotic treatment fails to reduce wound infection rates in contaminated abdominal surgery. A controlled clinical trial

One hundred ninety patients with peritonitis at the time of abdominal surgery were allocated at random to systemic antibiotic treatment alone or systemic antibiotic treatment combined with topical application of antibiotics in the wound at the time of wound closure. The overall wound infection rate was 17 percent without significant difference between the two treatment groups (P greater than 0.80).

Effects of beta-casomorphin in isolated heart preparations

beta-Casomorphin-5, a novel opioid peptide Tyr-Pro-Phe-Pro-Gly, was tested in isolated heart preparations of guinea pigs in comparison with other morphine related peptides and cardioactive drugs. The substance induced a dose-dependent change in the cardiac contraction force, showing a positive inotropic effect in low concentrations (10(-9) - 10(-7) mol/l) but a cardiodepressive action at higher doses (10(-7) - 10(-5) mol/l). Similarly, potentiation phenomena due to varied pacing rates of right-ventricular strips were enhanced at 10(-8) mol/l and lowered at 10(-6) mol/l beta-casomorphin-5. The coronary flow continuously increased. The observed changes of heart action were not mediated by opioid receptors: specifically acting opioid peptides were without influence and naloxone had no inhibitory effect. Peptides with similar sequences may exert a regulatory role in cardiac function, possibly mediated by an influence on the cellular calcium fluxes. The results may prove to be useful for the detection and estimation of more stable and cardioactive peptides.

[Experimental studies of in vitro IFN induction by different polynucleotides in human cell culture systems]

Several polynucleotides were tested for interferon induction in comparison with the standard Poly (IC) in human diploid fibroblasts and in human leukocyte suspensions. We received high IFN-titre following superinduction of the polynucleotides in human fibroblasts. These results show that under superinduction conditions partly 3 times more interferon is induced in comparison with the standard inductor Poly (IC). The tested concentration of 10 micrograms/ml polynucleotides did not result in any IFN yields or only in very low ones in human leukocytes, which were only within the range of detectability.

Bacterial lysis of fibrin seal in vitro

We performed an in vitro study to determine whether certain bacteria may lyse a commercially available fibrin seal (Beriplast, Behringwerke, Marburg, FRG). Fibrinogen solution was mixed with actively growing bacterial cultures, and thrombin was added. During 20 days of incubation at 37 degrees C complete lysis was observed with a number of different bacteria, however, at different rates. Complete lysis within 1-5 days was observed for the following species (number of strains in parentheses): Streptococcus faecalis (3), Pseudomonas aeruginosa (2), Serratia marcescens (2), and Serratia liquefaciens (1). Lysis was observed after 6-10 days for Enterobacter cloacae (2), Morganella morganii (2), Escherichia coli (2), S. marcescens (1), and Klebsiella pneumoniae (2). Lysis after 11-16 days was observed for Streptococcus pyogenes (2), S. faecalis (2), and Staphylococcus aureus (2). Rapid lysis was associated with the ability of the strain to liquefy gelatin, i.e. the production of a protease.

In-vitro auxin transport in membrane vesicles from maize coleoptiles

When membrane vesicles from maize (Zea mays L.) coleoptiles are extracted at high buffer strength, a pH-driven, saturable association of [(14)C] indole-3-acetic acid is found, similar to the in-vitro auxin-transport system previously described for Cucurbita hypocotyls. The phytotropins naphthylphthalamic acid and pyrenoylbenzoic acid increase net uptake, pressumably by inhibiting the auxin-efflux carrier.

Use of reference specimens for throat swab cultures on Streptocult

Seventy-five general practitioners (GPs) who regularly used Streptocult for culture of throat swabs participated in a study aimed at evaluating the need for and the possible educational effect of examining reference specimens. Their pre-study and post-study accuracy in the interpretation of cultures of simulated throat specimens were analyzed. One group of 38 GPs received instructions as well as supplementary reference specimens during the study, while no instructions were given to the remaining 37 GPs. There was no discernible difference in the post-study accuracy of the two groups. Before the study, 80% of the GPs had felt to be in need of reference specimens; after the study, 61% did so. A majority suggested that three reference specimens should be distributed once or twice a year. Eighty-six per cent had never checked the temperature in their incubator. After doing so, only 54% measured a temperature within the recommended range of 35-37 degrees C.

Influence of antibiotic treatment on the isolation rate of group A streptococci from peritonsillar abscesses

In a prospective one-year study, group A streptococci were cultured from pus specimens from 13 of 71 patients (18%) with peritonsillar abscesses. The isolation rate was significantly lower (7/57 = 12%) in patients who had received antibiotic treatment before specimen collection than in patients who had not received such treatment (6/12 = 50%). Group A streptococcus antigen detection tests on pus, using a commercially available diagnostic kit, had a low sensitivity (5/13 = 38%). It was concluded that in patients treated with antibiotics prior to collection of specimens, the absence of group A streptococcus on culture does not rule out that this organism could have been the principal etiologic agent.